Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

pharm exam 2 > drug therapy coronary heart disease > Flashcards

drug therapy coronary heart disease Flashcards

(51 cards)

Start Studying
1
Q

chronic coronary artery disease (CAD) results from

A

damage to the intima (inner layer) of coronary arteries = build up of lipids and fiber in lumens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CAD is also known as

A

the narrowing or blockage of the coronary arteries, usually caused by arteriosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is arteriosclerosis

A

hardening or clogging of the arteries; a build up cholesterol and fatty deposits (plaques) on the inner walls of the arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

plaque in the arteries to what

A

decrease the diameter of the artery, increasing macrophage to degrade the plaque, resulting in the plaque rupturing = endothelium injury, aggrevates platelet = thrombus = release of chemical mediators thromboxane, serotonin, platelet regrowth = vasoconstriction = further narrowing coronary arteries, less oxygen to tissue and worsen myocardial ischemia (reduced blood flow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

symptom of coronary heart disease

A

chest pain, very very bad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

risks factors for developing CAD

A

smoking, abnormal cholesterol level(hyperlipidemia), high BP, obesity, DM, little exercise, age (men>45, women>55), ethnicity, hx of preeclampsia, genetics(male<55, female<65)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CAD clinical manifestation

A

stable angina, variant angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is stable angina

A

classic, typical, exertion angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what results from stable angina

A

when myocardial O2 demand is greater than the O2 supply to the heart muscle; from exercise, physical exertion elemental exposer to the cold emotion/stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

substernal chest pain (CP) is what; part of stable angina

A

squeezing, may radiate to jaw, neck, shoulders, arm (brief: 5 mins- O2 restoration helps)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

signs of substerbal CP/ stable angina

A

SOB, diaphoresis, N/V, mistaken for arthritis pain/ GI disturbances, gender differences exist in symptom quality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

treatment for stable angina

A

thrombolytics(lyse the clot) & interventional therapies; calcium channel blockers, beta blockers, nitrates (relieve s/sx), increase exercise tolerance and life, delay CAD progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what Is variant angina

A

occurs at rest/ minimal exertion, occurs at same time of day, cyclic 3-6 months subsides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

acute coronary syndrome (ACS)

A

unstable angina; acute pain occurs at rest and lasts longer than 20 mins; can occur hours/ days prior to acute myocardial infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

2 types of myocardial infarcts (MI)

A

nstemi and stemi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

nstemi MI

A

non ST elevate myocardial infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

stemi MI

A

greater than 20 minute persistent ST elevation on ECG; very dangerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

labs for myocardial infarctions

A

creatine kinase: cardiac isoenzyme(shows damage to the heart); cardiac troponin 1 & troponin T: biomarker of myocyte injury(cell damage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

nonpharmacologic management of CAD

A

lifestyle changes & medications; obesity, stop smoking, patient education, interventional procedures (cardiac catheterization, coronary artery bypass graft, intracoronary stent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

antianginal agents used to

A

improve O2 delivery or decrease consumption; used alone of in combination with other cardiac medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

abtianginal agents will

Study These Flashcards
A

dilate blood vessels, decrease cardiac workload

22
Q

types of antianginal agents

Study These Flashcards
A

nitrates, beta adrenergic blockers, calcium channel blockers

23
Q

nitrates are

Study These Flashcards
A

potent vasodilators

24
Q

examples of nitrates

Study These Flashcards
A

nitroglycerin, isosorbide dinitrate

25
therapeutic actions of nitrates
relax and dilate veins, arteries, and capillaries(systemic vascular dilatation): increase blood flow, lower systolic pressure; relief of and prevention of angina pain; decreases preload and after load
26
adverse effects of nitrates
severe HA, dizziness, bradycardia, syncope, hypotension/ orthostatic
27
what other symptom may you see with the use of nitrate
reflex tachycardia in response to hypotension (heart thinks it needs to speed up)
28
how is nitrate given
may be SL(first pass effect with SL)(most common: 3 dose q 5 min/ while administering 3rd dose call 911 if at home), translingual spray, transdermal patch, topical ointment, PO, or IV
29
the half of nitrate
rapidly absorbed/ half life = 1 to 4 minutes
30
where is nitrate metabolized
in the liver, excreted in urine
31
nursing considerations for nitrates
check vitals, BP prior and after administration (should see a drop)
32
beta-adrenergic blockers examples
atenolol, metoprolol, bisoprolol (cardio selective)
33
therapeutic actions of beta adrenergic blockers
decrease cardiac workload by slowing HR, decrease BP and reduce contractility(increase O2 to the heart), cornerstone daily med for patients with angina, decreases need for SL nitroglycerin for angina
34
beta adrenergic blockers treats
angina, HTN, prophylaxis/ tx post MI
35
caution of beta adrenergic blockers
in 2nd/3rd degree heart block, cariogenic shock, severe bradycardia, hypotension, heart failure
36
black box warning on beta adrenergic blockers
do not stop abruptly, taper off; its well tolerates in patient with renal impairment/ may slow renal function decline
37
example of calcium channel blockers
nifedipine
38
therapeutic action of calcium channel blockers
inhibit the influx of calcium entering through slow channels, producing vasodilation of the peripheral blood vessels and coronary arteries (it does not affect the HR)
39
pharmacokinetics of calcium channel blockers
first pass metabolism in the liver, fecal and urinary excretion
40
adverse effects of calcium channel blockers
hypotension, flushing, HA, dizziness, lower limp edema, reflex tachycardia; dose related
41
nursing considerations when using calcium channel blockers
check vitals, BP prior to and after administration (grapefruit juice will increase effect of medications/ do not use with adrenergic stimulants(cocaine), will increase digoxin levels
42
adjunctive abtianginal drugs
ranolazine, dyslipiemic drugs, antihypertensive, morphine, anti platelets
43
ranolazine is what
anti-ischemic metabolic modulator = first line tx for chronic angina
44
dyslipidemic drugs do what
management of patients with major risk factors for atherosclerosis and vascular disorders (CAD, stroke, and peripheral arterial insufficiency)when lifestyle changes alone do not reduce blood lipids
45
antihypertensive drugs do what
decrease peripheral vascular resistance can tx angina (ex. ACE inhibitors)
46
morphine does what
helps pain/ anxiety, decreases preload; primary deliver in pain management in post MI in patients with unacceptable levels of pain
47
antiplatelets examples/ do what
aspirin: at lower doses effectively suppress platelet aggregation w/o affecting important endothelial cell function; adenosine diphosphate (ADP) receptor antagonists: similar effects; glycoprotein (GP): inhibit platelet aggregation as well
48
what is the purpose of giving thrombolytic agents following a stemi
is to dissolve thrombi and reestablish blood flow as quickly as possible, prevent or limit tissue damage, and maximize functional improvement. the antiplatelets are daily medication for prevention
49
goals of therapy for antianginal drugs
relieve acute anginal pain, reduce number and severity of acute annginal attacks, improve exercise tolerance and life quality, delay progression of CAD, prevent MI and sudden cardiac death
50
tolerance to long acting nitrate- antianginal drugs
develops with high dose, uninterrupted therapy; decrease adverse effects and efficacy
51
preventing tolerance strategies: administer lowest effective dose and?
avoid ling acting forms of nitrates, only use long acting forms during waking hours

pharm exam 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions